medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2023-222medsovet-7721Research ArticleЭНДОКРИНОЛОГИЯENDOCRINOLOGYГликемический контроль и сердечно-сосудистые осложнения сахарного диабетаGlycemic control and cardiovascular complications of type 2 diabetes mellitushttps://orcid.org/0000-0001-8317-7765ДрукИ. В.DrukI. V.

Друк Инна Викторовна - доктор медицинских наук, доцент, заведующий кафедрой внутренних болезней и семейной медицины ДПО.

644043, Омск, ул. Ленина, д. 12

Inna V. Druk - Dr. Sci. (Med.), Associate Professor, Head of the Department of Internal Medicine and Family Medicine of Additional Professional Education.

12, Lenin St., Omsk, 644043

drukinna@yandex.ruhttps://orcid.org/0000-0001-5852-2782СафроноваС. С.SafronovaS. S.

Сафронова Светлана Сергеевна - ассистент кафедры внутренних болезней и семейной медицины.

644043, Омск, ул. Ленина, д. 12

Svetlana S. Safronova - Assistant of the Department of Internal Medicine and Family Medicine of Additional Professional Education.

12, Lenin St., Omsk, 644043

svetasafronova1997@gmail.comОмский государственный медицинский университетРоссияOmsk State Medical UniversityRussian Federation202319082023013130140Copyright © Друк И.В., Сафронова С.С., 20232023Друк И.В., Сафронова С.С.Druk I.V., Safronova S.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/7721

За последние несколько десятилетий распространенность сахарного диабета (СД) в развитых и развивающихся странах резко возросла, что делает СД ключевым приоритетом здравоохранения во всем мире. Можно предположить, что увеличение продолжительности жизни пациентов с СД существенным образом влияет на показатель распространенности заболевания, поддерживая тенденцию к его увеличению. Пациенты с СД подвержены более высокому риску сердечно-сосудистых заболеваний и их неблагоприятных исходов в сравнении с общей популяцией. Патофизиологическая взаимосвязь между гипергликемией и сердечно-сосудистыми заболеваниями не вызывает сомнений. Контроль гликемии per se остается важнейшим условием успешного лечения СД, профилактики хронических осложнений заболевания и смерти. Контроль СД предполагает прежде всего достижение целевых показателей углеводного обмена. Использование гликированного гемоглобина (HbA1c), несмотря на известные ограничения чувствительности, стало стандартом оценки гликемического контроля у пациентов с СД. Раннее достижение целевого уровня HbA1c снижает риск диабетических осложнений, повышает вероятность длительного устойчивого контроля заболевания. В многочисленных клинических исследованиях продемонстрировано, что более высокий HbA1c и его большая вариабельность являются управляемыми факторами риска неблагоприятных сердечно-сосудистых событий. Оптимальная сахароснижающая терапия СД с целью снижения сердечно-сосудистых рисков должна обеспечить достижение целевого уровня гликемического контроля в максимально короткие сроки (первые 3 мес. терапии), удержание целевого уровня гликемии с минимально возможной вариабельностью HbA1c в последующие годы, должна быть безопасной. Своевременная интенсификация терапии, в том числе с применением инсулина, позволяет предотвратить негативные последствия длительной гипергликемии. Глар-100 имеет высокую эффективность и безопасность в сравнении с другими препаратами инсулина при инициации и интенсификации терапии СД 2-го типа. РинГлар® и Лантус® являются эквивалентными препаратами.

Over the past few decades, the prevalence of diabetes in developed and developing countries has increased dramatically, making diabetes a key health priority worldwide. It can be assumed that an increase in the life expectancy of patients with diabetes significantly affects the prevalence of diabetes, maintaining the trend of its increase. Patients with type 2 diabetes mellitus (DM2) are at higher risk for cardiovascular disease and its adverse outcomes compared to the general population. The pathophysiological relationship between hyperglycemia and cardiovascular disease is beyond doubt. Glycemic control per se remains essential for the successful management of diabetes, prevention of chronic complications of the disease and death. Diabetes control involves, first of all, the achievement of target indicators of carbohydrate metabolism. The use of glycated hemoglobin (HbA1c), despite known sensitivity limitations, has become the standard for assessing glycemic control in diabetic patients. Early achievement of the target HbA1c level reduces the risk of diabetic complications, increases the likelihood of long-term sustainable disease control. Numerous clinical studies have demonstrated that higher HbA1c and greater HbA1c variability are manageable risk factors for adverse cardiovascular events. Optimal hypoglycemic therapy for diabetes in order to reduce cardiovascular risks should ensure the achievement of the target level of glycemic control as soon as possible (the first 3 months of therapy), maintaining the target level of glycemia with the lowest possible HbA1c variability in subsequent years and therapy should be safe. Timely intensification of therapy, including the use of insulin, can prevent the negative consequences of prolonged hyperglycemia. Glar-100 has a high efficacy and safety in comparison with other insulin preparations at the initiation and intensification of DM2 therapy. RingGlar® and Lantus® are equivalent drugs.

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The authors declare that there are no conflicts of interest present.